Ocular immunology and inflammation · 2026
Clinical Outcomes in Toxoplasmic Retinochoroiditis: Comparing Intravitreal Clindamycin with and Without Adjunctive Steroids.
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Lam Sophia S, Wong Amanda, Wilkins Carl S
Аннотация
PURPOSE: The goal was to compare the clinical characteristics and visual outcomes of patients treated with intravitreal clindamycin with and without adjunctive steroids for vision-threatening toxoplasmic retinochoroiditis.
METHODS: A single-center retrospective cohort study of all toxoplasmic retinochoroiditis cases from January 1, 2013 to December 31, 2024 treated with intravitreal clindamycin was reviewed. Patients with vision-threatening disease and ≥3 months of follow-up data were included. Data collected included best-corrected visual acuity (BCVA), retinitis zone, aqueous and/or vitreous tap polymerase chain reaction results, number and type of intravitreal injections and systemic medications, complications and recurrence rates.
RESULTS: A total of 21 eyes from 20 patients were included. All patients were placed on oral antibiotic treatment. About 28.6% of eyes (6/21) received oral steroids, 28.6% of eyes (6/21) received adjunctive intravitreal dexamethasone injections, 23.8% of eyes (5/21) received both, and four eyes did not receive any adjunctive steroids. A mean of 3.2 intravitreal clindamycin injections were administered from initial to last follow-up visit. There was a statistically significant improvement of 0.54 logMAR in visual acuity regardless of treatment regimen (p < 0.008). Adjunctive corticosteroid exposure did not have a statistically significant difference in BCVA in this small retrospective cohort (p = 0.47).
CONCLUSIONS: Patients with toxoplasmic retinochoroiditis treated with intravitreal clindamycin had significantly improved BCVA. The addition of intravitreal or oral steroids did not have a statistically significant difference on vision or complication rates in this small retrospective cohort. No cases of injection-related endophthalmitis or lens injury were observed, but the small sample size limits conclusions regarding safety.
METHODS: A single-center retrospective cohort study of all toxoplasmic retinochoroiditis cases from January 1, 2013 to December 31, 2024 treated with intravitreal clindamycin was reviewed. Patients with vision-threatening disease and ≥3 months of follow-up data were included. Data collected included best-corrected visual acuity (BCVA), retinitis zone, aqueous and/or vitreous tap polymerase chain reaction results, number and type of intravitreal injections and systemic medications, complications and recurrence rates.
RESULTS: A total of 21 eyes from 20 patients were included. All patients were placed on oral antibiotic treatment. About 28.6% of eyes (6/21) received oral steroids, 28.6% of eyes (6/21) received adjunctive intravitreal dexamethasone injections, 23.8% of eyes (5/21) received both, and four eyes did not receive any adjunctive steroids. A mean of 3.2 intravitreal clindamycin injections were administered from initial to last follow-up visit. There was a statistically significant improvement of 0.54 logMAR in visual acuity regardless of treatment regimen (p < 0.008). Adjunctive corticosteroid exposure did not have a statistically significant difference in BCVA in this small retrospective cohort (p = 0.47).
CONCLUSIONS: Patients with toxoplasmic retinochoroiditis treated with intravitreal clindamycin had significantly improved BCVA. The addition of intravitreal or oral steroids did not have a statistically significant difference on vision or complication rates in this small retrospective cohort. No cases of injection-related endophthalmitis or lens injury were observed, but the small sample size limits conclusions regarding safety.